Application of computer-assisted pre-operation plan for the treatment of geriatric intertrochanteric femoral fractures

Abstract

Objective To discuss the curative effect of computer assisted pre-operation plan (CAPP) in treating the geriatric intertrochanteric femoral fracture. Methods The data of intertrochanteric fractures treated with PFNA-II between March 2012 and June 2015 were retrospectively analyzed. They were divided into two groups by preoperative design. One group was the CAPP group consisting of 53 patients with a mean age of 75.3 years (range, 60-92 years). According to the Evans Classification, there were 12 Evans type Ib, 9 Evans type Ic, 15 Evans type Id and 17 Evans type II fractures. The other group was the non-CAPP group consisting of 74 patients with a mean age of 76.6 years (range, 62-95 years). There were 18 Evans type Ib, 15 Evans type Ic, 20 Evans type Id and 21 Evans type II fractures. Operation time, intraoperative blood loss, times of fluoroscopy during operation and days of hospital stay were compared. The hip joint function was evaluated by Harris score at the final follow-up. Results The CAPP meanly cost 24.7 min. The consistency of the surgery and CAPP was up to 100%. In the CAPP group, the average operation time was 46.8±6.5 min; the average times of fluoroscopy during operation were 12.0±2.3 times; and the average blood loss was 154.4±27.6 ml. In the non-CAPP group, the average operation time was 57.8±10.3 min; the average times of fluoroscopy during operation was 20.9±3.2; and the average blood loss was 235.0±65.8 ml. All above data in the CAPP group were significantly lower than those in the non-CAPP group. The mean days of hospital stay were 13.9±1.3 days in the CAPP group and 14.3±1.4 days in non-CAPP group. The days of hospital stay had no significant difference between the two groups. Forty-five patients with an average follow-up period of 18.3 months were reviewed in the CAPP group. Fifty patients were followed up with an average period of 19.2 months in the non-CAPP group. At the final follow-up, the average Harris score was 88.6±2.8 points (range, 84-96 points) in the CAPP group and 87.5±3.2 points (range, 80-95 points) in the non-CAPP group. Conclusion CAPP system is convenient and efficient. It can facilitate the treatment of intertrochanteric fracture effectively. Key words: Hip; Fractures, bone; Fracture fixation, internal; Computer-aided design; Imaging, three-dimensional